THIS PAPER will confine itself to a discussion of surgical problems in reconstructing deficiencies of the middle ear sound conduction system. There will be no mention of preoperative workup and of treatment and selection of patients, which are so important to success. We have already covered this rather fully1-3 in previous publications. However, we are all prone to slight this important area, and in our office we routinely go through a check list to make sure that each patient has a complete evaluation before surgery: Tissues for Tympanic Grafting Over the past 12